This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Saturday, 15 January 2011

Housekeeper hell

I recently posted a comment in the comments section on my Wow, Peter post about the housekeeper re arranging everything on the ward so that equipment was impossible to find in an emergency. This was done because the previous set up was an inconvience to her.

Now I can top that story. Or just add to it really.

Another housekeeper who works about 5 hours a day 4 days a week recently insulted a medical doctor of ours.

He was preparing a tray to draw some bloods on a patient. Just as he got it all together his pager beeped and a voice came through it : " CARDIAC ARREST WARD 15, CARDIAC ARREST WARD 15". His patient on a ward 3 floors away had just stopped breathing. He dropped the tray on the counter top and ran down there, as is his duty. He ran like an athelete to get down there and help his patient.

The housekeeper came into the treatment room a minute later, saw his phlebotomy tray, and went nuts because the doctor "didn't clean up after himself". She went on and on about his "laziness" and "lack of consideration". He did not leave any kind of mess, just a tray with a syringe and blood tubes and some gauze. He would need that later when he came back from the emergency to draw bloods on my patient (a very difficult person to get bloods from).

She began to put all the equipment back. I told her that he would need it all again in about an hour or so and to leave it. She continued with the "lazy bastard" stuff. I let her have it. I couldn't help it. This medic was probably going to be working a 12+ hour day and he should not be worried about tidying things up to make like easier for the housekeeper. None of us should, I tried to explain to her that unlike her he has real responsibility and cannot delay treating a patient to make life easier for her. But I didn't get through that thick skull of hers. She was still pissing and moaning about it an hour later.

Shocking isn't it. And it happens all the time.

If you want to read more about lack of respect for Nurses and Doctors from the supposed "support staff" go here:

We have a hell of a lot of lazy and crap staff in the NHS who need to be disciplined and fired. But you won't find this amongst the professional nurses and doctors. We have a registration to protect. We take our jobs seriously. It is the low paid crap that we depend on that let us down constantly and are never dealt with that is the problem.

At 6 in the morning I had a patient deteriorate and as I was dealing with him all the other patients were ringing and shouting for help. Where was my health care assistant (the only other member of staff I had with me)? In the kitchen washing jugs and setting up for breakfast because the domestics would give her a smackdown if they came into work at 7AM and stuff wasn't done for them. She was actually afraid of them. I told the HCA not to worry about those slags and to give me a hand on the ward instead. The domestics came into to work and started on the HCA for not doing jobs for them and I told them off. Then they complain that they are being "bullied".

These people are untouchable. They are never disciplined or dealt with. The trust wouldn't hesitate to get rid of a Nurse or Doctor if something goes wrong but it seems as if everyone that we depend on just fucks around.
I had a ward clerk sat on the computer telling me that it wasn't her problem if the phone was ringing and that the Nurse should answer it.

38 comments:

To be fair alot of our housekeepers in my old trust and the trust I do placement in now are good, but I have seen a few come in where the usual housekeeper is sick and make a total mess of the place, which I suppose defeats the purpose of the role of the housekeeper.

Anne, get on the iPlayer and watch Hospital 24/7. It's a series being shown every weeknight on bbc wales this week documenting the heath hospital in cardiff. It will be available to everyone on the iplayer.

Now I am familiar with the heath for various reasons but not medical/surgical ward environments, just A&E. The episode I watched last night (episode 5) showed ward caterers and DIETETIC ASSISTANT that goes on the wards during meal times and helps patients get fed!!!

It's just as you say, if you don't have any clinical responsibility or professional registration at stake why would you give a fuck?

I've had emails from HR going on about how it is the doctors' responsibility to make sure shifts are covered because it is a 'professional duty' and we might get reported to the GMC! Fuck them, it isn't like they have much else to do other than arrange locums, how about I sit around for months at a time, doing nothing and failing to try and fill an empty rota slot I've known about all year and then pressure the already overworked junior docs already on the rota to cover it on the day before the shift, and they can do some clinical work running around the hospital for 13hrs straight while people die around due due to massive staff shortages.

Nice information about housekeeper hell. Housekeeper needed for gorgeous staffed home on the westside. A valued housekeeper lightens your workload and helps you to enjoy your home, ensuring every day that it is clean and presentable, comfortable. Thanks.

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In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.